Agenda and minutes

Apologies had been received from Dr Stephen Mather, Mr John Raine, Cllr David Parker, Cllr Frances Renton, Mrs Tracey Logan, Mrs Elaine Torrance, Mrs Jeanette McDiarmid, Mrs June Smyth, Mrs Clair Hepburn, Mrs Fiona Morrison and Mr David Robertson.

The Chair confirmed the meeting was quorate.

The Chair welcomed Mrs Angela Trueman to the meeting, who was replacing Mr Andrew Leitch as the User Carer Representative, non voting member of the Health & Social Care Integration Joint Board.

The Chair welcomed Dr Cliff Sharp, Interim Medical Director.

The Chair advised that Cllr David Parker was intending standing down from the Health & Social Care Integration Joint Board.  Subject to Scottish Borders Council approval the intention was that Cllr Iain Gillespie might join the Health & Social Care Integration Joint Board as the replacement for Cllr Parker.  The Chair welcomed Cllr Gillespie to the meeting as an observer.

The Chair welcomed Ms Linda Jackson to the meeting who was deputising for Mrs Fiona Morrison.

The Chair welcomed members of the public to the meeting.

The Chair sought any verbal declarations of interest pertaining to items on the agenda.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted there were none.

Monday 14 December 2015

The minutes of the previous meeting of the Health & Social Care Integration Joint Board held on 14 December 2015 were amended at page 3 last paragraph, line 1, to read ....”post diagnostic dementia...”, page 5, second to last paragraph to read “Mr David Davidson...” and page 8, third paragraph, line 2 to read “..spend of £470k..” and with those amendments the minutes were approved. 

Action Tracker

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the action tracker and agreed that the session that had taken place on 20 January 2016 had not fully accommodated the commissioning suggestion and the action would therefore return to amber.

Dr Eric Baijal gave an overview of the content of the plan and the next steps to be taken.  The Chair clarified that the document before the meeting was the Strategic Plan and a separate Commissioning and Implementation Plan would be drawn up.  

Mrs Susan Manion advised the meeting that it could not formally approve the Strategic Plan until the Health & Social Care Integration Joint Board had been legally established.  The date of legal establishment was 6 February 2016, she therefore proposed that the Strategic Plan be brought back to the next meeting for homologation.

The Chair confirmed that it was the content of the Strategic Plan that required approval as opposed to the finalised document. 

Cllr John Mitchell requested the population figures for Hawick and Galashiels be checked.

Progress Update – Chief Officer

The paper was tabled at the meeting and Mrs Susan Manion reminded the Health & Social Care Integration Joint Board (H&SC IJB) that an update report had been presented at the last meeting which had given a reassurance around governance arrangements and decision making processes. 

Mrs Pat Alexander commented that she was keen to have sight of all the appendices. 

The Chair advised that the H&SC IJB was noting the progress made against the projects that had already been approved.

Mr David Davidson reiterated that the H&SC IJB should receive their meeting papers seven days in advance to allow the members the time to read and scrutinise all of the content within the papers.

Cllr John Mitchell commented that all officials and staff were working hard and it was difficult to be kept up to date all of the time.

Cllr Jim Torrance commented that it was important that the paper was noted by the H&SC IJB.

Mrs Evelyn Rodger suggested that it might be helpful for the next report to look at stress and distress, how many staff had been trained, were going to be trained, what difference it had made to front line staff, etc.  She suggested that level of granularity would have been detailed within the bid and it would be helpful for the H&SC IJB to view progress being made.

Mr Davidson further commented that it would be critical for the H&SC IJB to receive progress reports for each project on how it was progressing against each stage in its timeline.  Progress reports would give the H&SC IJB the ability to be able to scrutinise where any issues might lie and offer direction.

Mrs Manion advised that the H&SC IJB would receive a full report on the Integrated Care Fund after the end of the financial year. 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the progress update report.

Mrs Susan Manion gave an overview of the content of the report highlighting the anticipated final approval of the Scheme of Integration on 6 February 2016, formal appointment of the Chief Officer and Chief Financial Officer on 7 March.  She suggested the forthcoming Development session scheduled for 7 March would need to become a formal meeting to allow the H&SC IJB to recognise its’ legal establishment and requirements ahead of 1 April 2016.

A discussion ensued which encapsulated several issues including: the huge amount of work that had been undertaken by Mrs Manion and her team in order to address the delayed discharges situation in extreme circumstances; achievements to date against the 72 hours target, possibly through a graphic detailing target, trajectory, etc; information on the GP contract and their input to design localities and clusters; status of the Physiotherapy 9 week target as a local stretched target; request for more detail within the categories of reporting, such as graphical trends, so that it would be easier to assimilate and compare; ongoing work on the performance monitoring framework; and oversight of performance.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the report.

Verbal update by Communications Officer

Ms Carin Petterson gave an update.

Dr Angus McVean commented that he would be more than happy to provide GP input to future newsletters.

During discussion several issues were raised including: staff engagement; information technology issues; integration website; reinstatement of the Communications Group to look at information available to the staff and public and links to existing websites; make the newsletter balanced and give a preview of items for the following issue; emphasis that primary care is about a whole range of services and teams and not just GPs;

Ms Linda Jackson commented that she would be willing to provide information and stories for the newsletter form the carers sector.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the update.

Mrs Susan Manion suggested taking both the Audit Committee and Internal Auditor papers together as one single discussion.  She highlighted that within the Scheme of Integration it was clear that the H&SC IJB may wish to establish an Audit Committee and in order to ensure the Audit Committee functioned appropriately the of a Chief Internal Auditor would be vital.

Mrs Jill Stacey confirmed that a key part of any organisation was to have effective governance arrangements in place and in order to ensure transparency, scrutiny and assurance an Audit Committee would be required.

Mrs Stacey advised of a slight revision to the wording of point 7 in Appendix 1 of the Audit Committee paper. 

A discussion followed which highlighted: membership of the Audit Committee and skill sets required; risk management strategy for the H&SC IJB to take account of commissioning risks and be shared with the Joint Staff Forum;

The Chair suggested voting members of the H&SC IJB consider if they wished to be a member of the H&SC IJB Audit Committee.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD agreed to establish an Audit Committee as part of the governance arrangements of the Health & Social Care Integration Joint Board.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD approved the Terms of Reference of the IJB Audit Committee as detailed at Appendix 1 with the suggested revision.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD appointed Jill Stacey, Chief Officer Audit and Risk, Scottish Borders Council as Chief Internal Auditor for the Integration Joint Board.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the content of the report.

Mrs Carol Gillie introduced the report 9 months into the financial year reminding the H&SC IJB that the budget was on an aligned basis and any pressures were the responsibility of the respective partner organisations. 

Mrs Gillie advised that the projected year end position was that the partnership would end the year with a £466k expense over budget.  It was an improved position following projected breakeven position for Scottish Borders Council services within the delegated functions. The projected overspend at the year end was linked to NHS services, principally GP prescribing and dental services.  

Discussion focused on several elements including: reduction in number of clients in residential care; impact of the living wage on the care sector; Scottish Government settlement for Local Authorities; understanding the impact of underspends against delivery of services; and the shift in budget alignment to assist integration of services.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the report.

Mrs Carol Gillie reminded the H&SC IJB that a more detailed session had been undertaken at the Development session in January.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the content of the report and agreed the content of the Draft Financial Regulations. 

The Chair noted that the previous two meetings of the Strategic Planning Group had been inquorate and a discussion took place on how to strengthen the group with suggestions including: reducing the quorum number; support from H&SC IJB members; virtual working through email discussion, input and approval of items; OD plan; financial representative to be included in the group membership; nursing input to the group; deputies to be nominated; terms of reference and membership to be shared; meetings to be planned across the year;

Dr Eric Baijal advised that he would circulate to the H&SC IJB the Terms of Reference, Membership, Remit and Governance arrangements.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the minutes.

Mrs Carol Gillie commented that it was a good background information document and she advised that there were 2 further follow up reports to be released. 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the report.

Mrs Susan Manion advised that a draft job description had been drawn up with the agreement of both Scottish Boarders Council and NHS Borders and it had been agreed that an appointment would be made on an Interim basis for a period to be identified.   

Mr Paul McMenamin had been identified as an Interim appointee on a secondment basis to ensure the H&SC IJB was assured around its financial arrangements from 1 April 2016 onwards.

Mrs Manion proposed the detail of the process to be followed to recruit, timeline and secondment period be shared with the H&SC IJB at its next meeting. 

The Chair suggested speaking to other H&SC IJBs regarding sharing the Chief Financial Officer post.

Mrs Carol Gillie confirmed that both she and Mr David Robertson would fully support Mr Paul McMenanmin in the role of Chief Financial Officer for the H&SC IJB. 

Mrs Karen Hamilton suggested costing the resourcing and staffing implications in other areas as she was aware there were a number of staff across both organizations providing support to the H&SC IJB through their professional roles.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the job description.

16.1     Development:  Mrs Susan Manion highlighted that Mr George Hunter had moved on.  He has provided a written report which would be fed into the OD work.

16.2     Meeting:  The Chair confirmed that the next meeting of the H&SC IJB would be held on 7 March at 9.30am as alluded to earlier in the meeting.

16.3     National H&SC IJB Chairs & Vice Chairs:  The Chair gave feedback from the national H&SC IJB Chairs and Vice Chairs meeting held on 28 January.  She highlighted: national indicators and what success will look like; key indicators; whole system approach; delayed discharges; political aspirations; shifting resources; and commissioning services.

Cllr John Mitchell enquired if there was any feedback on the Highland partnership that had gone Lead Agency.  The Chair advised that those from Highland had advised it had been a painful process but they felt it was now working well.  Mrs Jane Davidson reminded the meeting that in Highland there were two partnerships and one had been the Lead Agency model and the other had been the Body Corporate model.

Monday 7 March 2016 at 9.30 am in the Council Chamber, Scottish Borders Council

The Chair confirmed that the next meeting of Health & Social Care Integration Joint Board would take place on Monday 7 March 2016 at 9.30am in the Council Chamber, Scottish Borders Council.